“Doc, when I travel abroad, I take a lot of pre-packaged Indian food with me. Is that good?” “My son takes packaged noodles for each meal. Will it harm his growth and health?” Such questions from my patients are increasing daily, and so is the consumption of processed foods. Currently, up to 30 per cent of the populations in low-middle income countries are consuming them. In India, consumption of processed foods has doubled since 2012.
What are processed and ultra-processed foods?
Any food that is altered in some physical or chemical way (mostly industrial) is termed as processed food. When five or more industrial formulations are added using sophisticated industrial equipment, it is called ultra-processed food. After cleaning, freezing, parboiling, and frying, several ingredients are added, which is the most harmful step for health. Some of these ingredients include whey protein, gluten, casein, lactose, hydrogenated oils, hydrolysed proteins, soy protein isolate, maltodextrin, invert sugar and high fructose corn syrup. Then these foods, in attractive packages, are ready for all convenience stores and super bazaars. Processing of various foods increases their taste and shelf life.
Common examples of processed foods include breakfast cereals, canned products, instant soups, instant meals/noodles, flavoured potato chips, flavoured candy bars, energy bars, table sauces, reconstituted meats (eg, sausages) and so on. Some examples of ultra-processed foods available and consumed in India include packaged baby cereals, packaged fruit juices, sweetened carbonated beverages, energy drinks, sweet Indian packaged snacks, ‘health’ drinks, most biscuits and prepared pastas or pizzas. The only “good” part is that these foods taste good and many people are addicted to them.
What are harmful ingredients in processed foods?
There could be multiple problems with consumption of processed foods. These are high in calories, salt and sugar. More importantly, these foods have a high content of trans fats, a form of fat which is highly damaging to human health. Good nutrients such as protein and fibre are generally low.
Additionally, and poorly researched, these foods contain harmful additives and newly formed compounds. Further, the packaging may contain chemicals which are known as hormone disruptors, which may affect health in yet unknown manner. For example, the following elements could be damaging to health.
1. Carrageenan and carboxymethylcellulose (CMC): Thickening agents commonly employed in meat and dairy product formulations, (have been shown to be associated with intestinal inflammation).
2. Emulsifiers and stabilisers: These are commonly added to processed foods, have the potential to cause metabolic disturbances.
3. Packaging Contaminants:
a. Synthetic compounds like bisphenol A are widely present in food packaging, have potential to impair reproductive function in men and increase cancer risk.
b. Phthalates are another class of synthetic chemicals commonly used in food packaging and have the potential to act as xenohormones (chemicals which could produce human hormone like effects).
What are the bad health outcomes of processed foods?
One outcome which is consistent across many studies is weight gain. This is mostly seen in young individuals and is particularly worrisome for India, where childhood obesity is on the rise. A closely related association is “metabolic syndrome”, a conglomeration of various risk factors including obesity (specifically excess abdominal fat), high blood pressure and blood sugar, and deranged cholesterol profile. Currently about 1/3rd of the urban Indian population has this syndrome. This metabolic syndrome is a forerunner to heart disease. A few studies show that excessive consumption of processed foods is linked to bowel irregularity. While COVID-19 has increased the number of people with mental health problems, depression has also been linked to processed foods.
But there are more severe outcomes linked to processed foods; diabetes is one, heart disease, stroke, and deaths due to any cause are the other dangerous ones. And research is just beginning on many other outcomes like cancers.
I fear eating processed foods. What do I eat now?
Many patients ask me, “Doc, eating is one of the prime pleasures of life. How can I stop eating my food like this?” My usual answer is, “limit your processed food intake to one day a week, and rest of the days eat more of unprocessed foods. And read the front of package labels while buying any packaged foods from the market, thus limiting your choices to those with least salt, sugar, and fat contents.” I further emphasise that the industry advertising (often by celebrities) is mostly misleading, do not go by them. Genuine sources of information include World Health Organisation (WHO), Govt of India, and some public interest groups.
Finally, and most importantly, have “real food”. These unprocessed foods include fresh fruits, vegetables, whole grains, nuts, meat, legumes, curd (not flavoured yoghurt) and milk. Cook at home the traditional way but with healthy oils with less saturated fats, and eat fresh.
(Dr Misra is Padma Shree awardee and is author of the book Diabetes with Delight)